No abstract

Coronaviruses are known to be responsible for infections in humans since the 1960s and have accounted for epidemics in recent human history. More recently, in 2019, a disease caused by a new coronavirus appeared in China, in the province of Wuhan, with a characteristic of greater infectivity, called COVID-19, which has caused a new world pandemic. Considering the need to contain the advance in the number of cases, based on the high rate of transmissibility, several countries have adopted extreme social distancing measures, including the so-called ‘lockdown’. Despite the socioeconomic side effects, the aforementioned measure reduced the progression of the pandemic in countries that adopted it. In Brazil, the state of Ceará was one of the first epicenters of the disease in the country and the state capital city of Fortaleza, on May 8, implemented the lockdown measure to contain the increase in the number of cases. It was then observed, in a tertiary hospital, which is a referral for COVID-19 cases, a decrease in the daily occupancy rate of beds reserved for the pandemic after the lockdown onset, evidencing that this measure leads to a sustainable reduction in bed occupation rates, thus preventing the collapse and overload in health services.

Aim: To investigate the association between cardiovascular risk and biomarkers in patients with Type 2 diabetes (T2DM). Methods: Cross-sectional study, with evaluation of traditional and new biomarkers (serum FGF-23, Syndecan-1 – Sdc-1 and vascular cell adhesion molecule-1 – VCAM-1 and urinary VEGF and kidney injury molecule-1 – KIM-1) and risk scores (Framingham-FRS and UK Prospective Diabetes Study – UKPDS). Results: 128 diabetics were included, with predominance of high risk by FRS and low risk by UKPDS. There was an independent association of VCAM-1 and VEGF with higher risk by FRS-lipids and UKPDS. Conclusion: There was an independent association of VCAM-1 and VEGF with higher cardiovascular risk, showing a subclinical endothelial dysfunction in T2DM. The inclusion of novel biomarkers to risk scores may increase accuracy when assessing cardiovascular risk of diabetic individuals.

Wolff–Parkinson–White (WPW) syndrome is a conduction disturbance in which atrial impulses are transmitted to the ventricles by an accessory pathway instead of the normal atrioventricular conduction. The WPW syndrome may either simulate myocardial infarction or mask the electrocardiographic abnormalities of an acute MI. However, concealed WPW revealed after an acute coronary syndrome is rare with few cases reported in the literature. This article reports a case of coronary artery disease with ST‐segment elevation in a 57‐year‐old man, previously asymptomatic, with an initial electrocardiogram showing no conduction abnormalities that subsequently presented with an ECG compatible with WPW.